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Thursday, July 26, 2012

One of the big news stories of the day focuses on the decision by multiple hospitals in Colorado to waive the cost of treatment for victims of our most recent mass shooting. I found my self wondering how bizarre this must appear to members of other civilized societies. On the one hand, Americans regularly (and, often, loudly and vociferously) proclaim their adherence to the precepts of the Church of Capitalism. They are comfortable meshing the access to health care with the same principles regularly applied in the field of commerce. The idea that other thoughtful, educated, reasonable people around the globe have long since abandoned the practice of leaving their citizens to fend for themselves with regard to basic health care, leaves Americans unfazed, unconvinced and even perplexed. Except for the fact that– this is not exactly the case.

As we begin to drill down and deconstruct American health care policy and practice, it becomes evident that we are really of two minds in this. Or, three. Or more. Upon reflection the whole thing is reminiscent of our policies and practices with regard to race and other social issues. Perhaps these connections will become apparent to the reader as we proceed. Or, perhaps, not. (Some of my other blog posts may help to clarify.)

One of the first things Americans decided, while perched high upon their throne of Capitalism, was to circumvent one of the basic tenets of their religion– market forces. But, oddly enough, that is not the interesting part. What draws in the curious mind, is the fact that they decided (legislated) who would be exempt from market forces. In an effort as warm-and-fuzzy as it gets, they decided that health care for elderly citizens, who were after all frail and no longer employed, would be wholly or partly subsidized. Even the strictest disciples of Capitalism found their heart-strings plucked by this 'exception'. The basic underpinnings of the Church were deemed sound and life went on. A hearty, "well played" all round.

The next set of troubles followed swiftly and predictably on the heels of the first. In a word, veterans. Goodness, gracious me. We couldn't have brave Amerians soldiers who have fought for our freedoms to be subject to the law-of-the-jungle when they require health care. Such a thing would be darn near anti-American. Legislators and citizens alike got all weepy and, in due course, disaster was averted. Slaps on the back all round. Again, well played.

For those with above average predictive abilities, you will have seen the next set of challenges on the horizon. Of course, it would be poor folks and children. And, after some grinch-like grumbling, these vulnerable citizens are also exempted from the forces that Americans 'believe in'.

Again, for those precocious predictors, this will come as no shock. From relatively humble beginnings, our little exemptions have grown and multiplied like, well, rabbits. We start out with a few "old folks" ( and they were few mainly because most did not live to become old folks at that time) and, the next thing you know, we no longer have exceptions. We could safely state, the exceptions have become the rule. One would be forgiven for running a silent tally in ones head to determine who we missed in our exemption free-for-all.

At the risk of appearing to take a sledge hammer to a flea, allow me to finish this way. After long observation and association with Americans, I can unequivocally call them a generous people. I can also say, without reservation, that they could hardly be more quirky or capricious in their generosity. There is something about the attempt to weave together disparate parts of the American psyche that leaves an observer gobsmacked. The determination and can-do spirit often leaves one in awe. The yankee-ingenuity regularly inspires. And, frankly, the ability to inexplicably exclude members of their own society from the benefits of that society leave this observer near despair.

**Note to the persnickety. My casual history is not meant to be taken as a literal chain of events. Programs for veterans and the poor can be traced to early America.